TCT-1233 Three-Dimensional Reconstruction Compared to Two-Dimensional Quantitative Coronary Angiography for Assessment of Coronary Lesions in Guiding Percutaneous Coronary Intervention: A Meta-Analysis
Recommended Citation
Gupta P, Hamza M, Hajeh H, Gopal S, Patel M, Zulaid A, Mahmoud A, Mahmood A, Ramachandran SP, Burhan M, Alraies M. TCT-1233 Three-Dimensional Reconstruction Compared to Two-Dimensional Quantitative Coronary Angiography for Assessment of Coronary Lesions in Guiding Percutaneous Coronary Intervention: A Meta-Analysis. J Am Coll Cardiol 2025; 86(17 Supplement):B530.
Document Type
Conference Proceeding
Publication Date
10-28-2025
Publication Title
J Am Coll Cardiol
Abstract
Background: Accurate assessment of coronary lesions is critical for planning percutaneous coronary intervention (PCI). While two-dimensional quantitative coronary angiography (2D-QCA) is the clinical standard, it is limited by foreshortening, overlap, and projection dependency, which can misrepresent lesion severity. Three-dimensional reconstruction (3D-R) offers a more precise alternative compared to 2D QCA. Methods: We searched PubMed and Embase from inception to July 2025 and identified 239 studies. After removing duplicates and non-relevant records, we included those studies that used validated software to generate 3D-R and compared them with 2D-QCA. Quantitative endpoints included lesion length, reference vessel diameter (RVD), minimal luminal diameter (MLD), and percent stenosis (PS). A random-effects model with a standardized mean difference (SMD) was used. Results: Out of 5 included studies, four studies with 280 coronary segments from 194 patients reported both lesion length and RVD, two studies with 95 segments from 96 patients reported MLD, and four studies with 242 (3D-R) vs. 260 (2D QCA) segments from 216 patients reported PS. Lesion length was longer with 3D-R (SMD: 0.38, CI: 0.20-0.55, p< 0.00001). PS was lower with 3D-R (SMD: -0.61, CI: -1.14 to -0.09, p=0.02). No significant difference in RVD and MLD. [Formula presented] Conclusion: 3D-R showed significantly longer lesion lengths and a lower PS than 2D QCA. These findings suggest that 2D-QCA may underestimate lesion length and overestimate stenosis severity. 3D-R offers a more precise method to evaluate lesions before stent selection, potentially improving PCI outcomes. Categories: CORONARY: Vascular Access: Coronary
Volume
86
Issue
17 Supplement
First Page
B530
